Evidence map›Paper›PMID 30959121›Full record

SynthesisInternational journal of radiation oncology, biology, physics2019

Stereotactic Body Radiation Therapy for Localized Prostate Cancer: A Systematic Review and Meta-Analysis of Over 6,000 Patients Treated On Prospective Studies.

William C Jackson, Jessica Silva, Holly E Hartman, Robert T Dess, Amar U Kishan, Whitney H Beeler, Laila A Gharzai, Elizabeth M Jaworski, Rohit Mehra, Jason W D Hearn and 11 more

4 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of radiation oncology, biology, physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 190 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
190citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04831983 recruitingnot on this mapstarted 2021, after this paper: background citation

Single-Dose Image-Guided Radiotherapy (IGRT) With Focal Boost to the MRI-defined Macroscopic Tumor Volume for Intermediate Unfavorable and High Risk Prostate Cancer

TypeobservationalSponsorUniversity of Milano BicoccaRan2021 to 2029Enrolled30ConditionsProstate Cancer
NCT05705921 naactive not recruitingnot on this mapstarted 2023, after this paper: background citation

Standard Moderately Hypofractionated Radiotherapy vs. Ultra-hypofractionated Focal Lesion Ablative Microboost in Prostate Cancer, Hypo-FLAME 3.0

TypeinterventionalSponsorThe Netherlands Cancer InstituteRan2023 to 2032Enrolled484ConditionsProstate CancerArmsRadiotherapy standard, Radiotherapy Hypo-FLAME
NCT05936736 narecruitingnot on this mapstarted 2023, after this paper: background citation

24 Gy in One Fraction Urethral-sparing "High-Dose-Rate Like" Stereotactic Body RadioTherapy for Prostate Cancer: a Single-center Non-randomized Prospective Clinical Study (PRO-FAST)

TypeinterventionalSponsorIRCCS San RaffaeleRan2023 to 2030Enrolled70ConditionsLocalized Prostate CarcinomaArmsprostate SBRT
NCT06027892 narecruitingnot on this mapstarted 2022, after this paper: background citation

Two-fraction Versus Five-fraction Stereotactic Radiotherapy for Localized Low- and Favorable Intermediate-risk Prostate Cancer: SABR-Dual

TypeinterventionalSponsorRabin Medical CenterRan2022 to 2032Enrolled562ConditionsPROSTATE CANCERArmsTwo-fraction stereotactic radiotherapy, Five-fraction stereotactic radiotherapy
3 · Its place in the literature

Who cites it

190 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  7. SABR for High-Risk Prostate Cancer: A Prospective Multilevel MRI-Based Dose Escalation Trial.International journal of radiation oncology, biology, physics · 2022
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130 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

William C JacksonDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Jessica SilvaDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Holly E HartmanDepartment of Biostatistics, University of Michigan, Ann Arbor, Michigan.
Robert T DessDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Amar U KishanDepartment of Radiation Oncology, University of California, Los Angeles, California.
Whitney H BeelerDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Laila A GharzaiDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Elizabeth M JaworskiDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Rohit MehraDepartment of Pathology, University of Michigan, Ann Arbor, Michigan.
Jason W D HearnDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Todd M MorganDepartment of Urology, University of Michigan, Ann Arbor, Michigan.
Simpa S SalamiDepartment of Urology, University of Michigan, Ann Arbor, Michigan.
Matthew R CooperbergDepartment of Urology, University of California, San Francisco, California.
Brandon A MahalDepartment of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts.
Payal D SoniDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Samuel KaffenbergerDepartment of Urology, University of Michigan, Ann Arbor, Michigan.
Paul L NguyenDepartment of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts.
Neil DesaiDepartment of Radiation Oncology, University of Texas Southwestern, Dallas, Texas.
Felix Y FengDepartment of Radiation Oncology, University of California, San Francisco, California.
Zachary S ZumstegDepartment of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
Daniel E SprattDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan. Electronic address: sprattda@med.umich.edu.

Funding

VACCINIA PSA FOR ANDROGEN-MODULATED POST-SURGICAL RECURRENCE OF PROSTATE CANCERP50CA069568 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHINNAIYAN, ARUL M · 1995 to 2013
$31.3M
Tissue/InformaticsP50CA186786 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu · 2014 to 2026
$27.6M
Biostatistics Training Program in Cancer ResearchT32CA083654 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Veerabhadran Baladandayuthapani, Kelley McLain Kidwell · 2002 to 2026
$4.3M
NCI NIH HHS P50 CA069568NCI NIH HHS P50 CA186786NCI NIH HHS T32 CA083654
6 · The paper itself

Abstract

purposeUtilization of stereotactic body radiation therapy (SBRT) for treatment of localized prostate cancer is increasing. Guidelines and payers variably support the use of prostate SBRT. We therefore sought to systematically analyze biochemical recurrence-free survival (bRFS), physician-reported toxicity, and patient-reported outcomes after prostate SBRT. METHODS AND MATERIALS: A systematic search leveraging Medline via PubMed and EMBASE for original articles published between January 1990 and January 2018 was performed. This was supplemented by abstracts with sufficient extractable data from January 2013 to March 2018. All prospective series assessing curative-intent prostate SBRT for localized prostate cancer reporting bRFS, physician-reported toxicity, and patient-reported quality of life with a minimum of 1-year follow-up were included. The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analyses were performed with random-effect modeling. Extent of heterogeneity between studies was determined by the I

resultsThirty-eight unique prospective series were identified comprising 6116 patients. Median follow-up was 39 months across all patients (range, 12-115 months). Ninety-two percent, 78%, and 38% of studies included low, intermediate, and high-risk patients. Overall, 5- and 7-year bRFS rates were 95.3% (95% confidence interval [CI], 91.3%-97.5%) and 93.7% (95% CI, 91.4%-95.5%), respectively. Estimated late grade ≥3 genitourinary and gastrointestinal toxicity rates were 2.0% (95% CI, 1.4%-2.8%) and 1.1% (95% CI, 0.6%-2.0%), respectively. By 2 years post-SBRT, Expanded Prostate Cancer Index Composite urinary and bowel domain scores returned to baseline. Increasing dose of SBRT was associated with improved biochemical control (P = .018) but worse late grade ≥3 GU toxicity (P = .014).

conclusionsProstate SBRT has substantial prospective evidence supporting its use, with favorable tumor control, patient-reported quality of life, and levels of toxicity demonstrated. SBRT has sufficient evidence to be supported as a standard treatment option for localized prostate cancer while ongoing trials assess its potential superiority.

Indexed as

Prospective StudiesClinical Trials as TopicConfidence IntervalsDose Fractionation, RadiationHumansMaleProstatic NeoplasmsPublication BiasQuality of LifeRadiosurgeryTreatment Outcome

Identifiers

PMID30959121
PMCPMC6770993

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.